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Haematuria (Blood In Urine)

Haematuria is the medical term given to the presence of blood in a patients urine. This can either be ‘macroscopic’, which can be seen by the patient or ‘microscopic’ which is only detectable using urine test sticks or when a urine sample is sent off for analysis.

The presence of blood in the urine could be a sign of an underlying problem and therefore should always be investigated. Should either you or your doctor detect the presence of blood in your urine then you should be seen initially by a urological surgeon.

Whilst a significant number of cases there will be nothing to worry about and no treatment required, in some cases the presence of blood could be as a result of conditions such as: infection, kidney or bladder stones, kidney, prostate, or bladder cancer.

Symptoms of Haematuria

Microscopic haematuria is most often associated with no symptoms and can easily be detected with the use of urine dipsticks. Whilst these tests do occasionally give a false positive result they are an excellent initial test for haematuria. If you are found to be positive for microscopic haematuria on a couple of occasions then your doctor should refer you on to a specialist (urologist).

Macroscopic haematuria is more obvious as the patient will see blood when passing urine. This is most often a bright red colour, but on some occasions old blood can look a dark brown or rusty colour. If you think you have seen blood in your urine then you should consult a doctor as soon as possible.

Common Causes of Haematuria

1. Bladder cancer: more common men, smokers and risk increases with age

2. Kidney cancer: more common in men, diabetics, family history, obesity and smokers

3. Prostate cancer: only effects men, more common with family history and afro-caribbean ethnic groups, risk increases with age

4. Kidney / Bladder stones: increased risk with poor fluid intake and some diets.

5. Infection: often associated with symptoms such as pain on passing urine and increased frequency.

6. Idiopathic: this is the term given to unknown cause, often despite a number of investigations the cause of haematuria will remain unknown.


In order to determine where the bleeding was/is coming from then you will need two further investigations.

1. CT scan or Ultra-sound scan. Both of these tests are primarily looking for abnormalities with you kidneys, they can however detect other conditions within your abdomen they may be unrelated to your original condition.

2. Flexible cystoscopy. This is performed as an out-patient procedure with topical local anaesthetic and involves the passage of a small fibre-optic camera into your bladder via the urethra (the tube you pass urine through). The bladder is filled with sterile fluid to allow a full inspection of its lining.